Laser medicine, particularly LLLT is one of the fast-growing fields in China, Ruby, He-Ne, CO₂, waveguide CO₂, YAG, neodymium glass, nitrogen, He-Cd, dye, argon and GaAlAs laser systems are developed, but He-Ne and CO₂ are the main popularized in LLLT. Multi-function, portable CO₂ laser system will soon become the most favourite, and spreading throughout China, The photobioactive effects of LLL irradiation and the meridian and acupoints of traditional Chinese medicine as the basis of laser acupuncture opened a very wide field for LLLT in China, LLLT has been applied in different clinical specialties, mainly internal medicine, skin surgery, dermatology, ophthamology, ENT, stomatology, obstetrics and gynecology, plastic surgery, laser acupuncture and veterinary medicine for hundreds of diseases with excellent and good effects. Up to the present, no national society dedicated to LLLT has been established, In the past 10 years, I have successfully applied laser acupuncture anesthesia for tooth extraction and minor facial cosmetic surgery, From 1985--1990, an advanced clinical trial on laser cosmetic surgery has been developed, LLLT has been proved significantly to ensure laser cosmetic effects, and also its use in conjunction with a newly devised depigmenting ‘Quen-zhi Cosmetic Cream ’ to control postoperative hyperpigmentation.

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An electron microscopy study of NIH fibroblastic cells irradiated with 632 nm and 360 nm light in the presence or absence of exogeneous porphyrins suggests that porphyrins are responsible for light-tissue interaction, A mechanism for phototherapy is considered.

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The effects of red (632 nm), green (540 nm) and infrared (904 nm) light sources on the peripheral nervous system were examined. Only the red and green wavelengths have an effect on the Compound Action Potential (CAP) of the nerve. This agrees with our hypothesis that porphyrins absorb the irradiated light. A light source which meets the requirements and specifications of our research is being built.

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Low level laser radiation therapy is effective in a number of clinical situations (e,g. pain relief, wound healing, sports medicine), but the photobiological basis of this therapy is not well-understood, Since both visible and infrared radiations have been shown to be beneficial in such therapies, and since these two radiations differ dramatically in their photochemical and photophysical properties, how can they produce similar results clinically? I propose a modification of the model of Karu¹ to explain this. In her model. visible light produces photochemical changes in photoreceptors in the mitochondria, which alter metabolism, which leads to signal transduction to other parts of the cell (including membranes), which finally leads to the photoresponse (i.e, biostimulation). While visible light probably starts the cascade of metabolic events at the level of the respiratory chain of the mitochondria through photochemical events (probably the photoactivation of enzymes), I propose that because of the photochemical and photophysical properties of infrared radiation, infrared radiation starts the cascade of metabolic events by photophysical effects on the membranes (probably the Ca⁺⁺ channels), Action spectra are needed to quantitate the relative effectiveness of the different wavelengths of radiation, since this can help to identify the photoreceptors for the photobiological response, and to establish the optimum conditions (i,e. wavelength, dose, and treatment schedule) for a particular therapy,

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Fibroblast viability, proliferation and metabolic changes were studied following in vitro irradiation with a continuous wave 10 mW helium-neon (HeNe) laser, Fresh first generation fibroblasts prepared directly from a healthy human skin sample were used in the culture. and a control set of unirradiated samples was handled in exactly the same way as the irradiated samples. Statistical analysis of the data showed no increase in the number of fibroblasts following low reactive-level laser therapy (LLLT) levels of radiation, but did reveal significant changes in metabolic rates compared with the unirradiated controls, Results of the assessment of the metabolic changes suggested that an efficient modality for enhancement or modulation of cell activity could be ascertained for laser irradiation at LLLT levels, and thereafter used for therapeutic purposes, following the elucidation of appropriate power and energy densities, and other parameters.

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Thirty-nine patients (25 female and 14 male) were treated for post-herpetic neuralgia (PHN). A linear analog scale from 0-10 was used to score the results (10 represents extreme pain. O represents no pain), A 904 nm low energy infrared laser pulsed at 4000 Hz (Hertz) was used, A laser head containing 10 diodes. emitting a total of 6 mW (milliwatts) per s was placed over the affected area for 20 min. Patients received approximately 7 joules of energy per treatment (five treatments = 1 session). Each treatment had a rest period of 4h before next treatment. Pain was reported for 6 months to 1 year on average. Subjects peak pain level was a mean of 8.54 (median = 9.00). Eighteen of 39 subjects (46.2%) reported the maximum pain level of 10 before treatment. At the end of treatment subjects scored their pain level at a mean of 3.28 (median = 2.00). After treatment 11 of 39 subjects (28.2%) reported a pain level of zero (no pain). One year later subjects rated their pain level at a mean of 2.74 (median = 1.00). Fifteen of 34 subjects (44,1%) reported a pain level of zero. For the sample (N = 39) increasing age is a significant predictor of level of pain from shingles (p < 0.05). For subjects aged 60 years or greater (N = 27). The reported level of PHN pain decreased significantly after treatment (p < 0.05).

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Secondary myogenic torticollis, or wryneck, results from difficulties during delivery, and is quite common in the neonate in the P.R,O.C. It is easily seen after birth, and can quickly develop into a painful chronic condition involving involuntary spasmodic contractions of the affected sternocleidomastoid muscle, accompanied mostly by swelling or occasionally by contracture. Conventional nonsurgical methods do not often prove effective, A study is presented with 154 infants suffering from secondary myogenic torticollis, ages ranging from less than 1 day to 6 years. One hundred and twenty-nine had received previous alternative treatment with no success, The infants in the group were treated with LLLT using a combination CO₂/HeNe laser (maximum incident power densities of 1,8 W/cm² and 3 mW/cm², respectively). LLLT was applied using the scanning, noncontact method along the affected muscle and surrounding tissue. for 10-15 min per session, with 10 daily sessions per course, followed by a 10-day resting period between courses. During the resting period, physical therapy was carried out at home by the parents, with heat treatment followed by gentle massage, and a regimen of stretching and torsion exercises. LLLT achieved a complete cure rate of 58.5% and an overall effective rate of 85%, the shortest treatment period being one course (23 infants) and 16 infants requiring the longest treatment period of six courses (16 weeks). The earlier the LLLT was administered, the higher the effective rate (95% under 1 month, 71% over 1 year-old). It is proposed that CO₂/HeNe LLLT for this condition offers a noninvasive and highly effective therapeutic alternative to conventional medical and surgical treatment methodologies for this painful and disfiguring complaint, especially in the very young patient.

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In Canada the primary users of LLLT are physiotherapists which constitute 49% of all systems in operation, Other medical professionals such as medical doctors, dentists and chiropractors using LLLT account for 26% with sports medicine at 5%, wholistic medicine at 2%, addiction control at 7% and homecare facilities at 5%. Private individuals and veterinary users report 1%, while acupuncturists account for 5% usage.

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